Provider Demographics
NPI:1891781043
Name:KITTS, LORI MARIE (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:MARIE
Last Name:KITTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 AMARYLLIS LN
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-4871
Mailing Address - Country:US
Mailing Address - Phone:248-835-4005
Mailing Address - Fax:
Practice Address - Street 1:714 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3068
Practice Address - Country:US
Practice Address - Phone:856-778-4009
Practice Address - Fax:856-778-4014
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08313600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH95739Medicare UPIN